BACKGROUND TO LYMPHOEDEMA TREATMENT IN THE UK

Historically in the UK lymphoedema has not been taken seriously as a debilitating condition which can lead to complications. The medical profession had little knowledge and many patients would be told that there was nothing to be done beyond perhaps taking water tablets regularly. They would be left to manage a worsening health problem. A few fortunate patients might be sent to Europe for treatment where lymphoedema clinics were well established or surgical reduction procedures in the UK would be carried out if swelling became too severe – the latter have never been very successful.

Eventually in the 1980s, a small team, led by Professor Mortimer who consults at St George’s Hospital in London, began a study of the conservative treatment model initiated in Europe. Over the last 25 years, this has led to more than 200 clinics being established in hospitals and hospices around the country in addition to some small private clinics to which patients may still be referred by the NHS depending on local funding.

The next hurdle was the training of lymphoedema therapists. Expertise was available mainly in Europe from such clinics as Foeldi (Germany), Vodder (Austria), and Leduc (Belgium) and also from Casley-Smith in Australia. To qualify, therapists would travel abroad and some still do although now there is the choice of attending courses in the UK for private therapists, NHS nurses, physiotherapists and occupational therapists.

It is fair to say that provision of lymphoedema care in the UK has improved greatly but still a lot of work needs to be done with the medical profession to gain an understanding how lymphoedema can lead to complications and how it affects a patient’s mobility and quality of life. Research and development is ongoing and much has been done in gene research and investigating new and hopefully more effective treatments.

There is still somewhat of a lottery regarding access to lymphoedema care in the UK and the actual extent of lymphoedema treatment at individual clinics can vary greatly. This is perhaps due to the varying limitations in funding together with the amount of importance placed on treating the condition. Most of the funding for treatment has come from cancer charities for allocation to treat secondary lymphoedema and primary lymphoedema patients have slowly been included. However, there is still often a limit to the number of primary lymphoedema patients that can be registered once a clinic’s list is overloaded.

There are too many people with lymphoedema for it to be insignificant and hopefully treatment provision will continue to improve and expand, accessed by all who need it.